Patient Results Report

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1 Sample Physician MD Sample Practice 2250 W. Campbell Park Dr. Chicago, IL Current Test Overview SAMPLE ID RESULTS TURNAROUND (IN DAYS) PATIENT COLLECTION LAB RECEIPT TEST COMPLETION S /03/ /04/ /06/2005 SAMPLE BARCODE Litholink's computer generated comments are based upon the patient's most recent laboratory results without taking into account concurrent use of medication or dietary therapy. They are intended solely as a guide for the treating physician. Litholink does not have a doctor-patient relationship with the individuals for whom tests are ordered, nor does it have access to a complete medical history, which is required for both a definitive diagnosis and treatment plan. Cys 24, Cys Capacity, Sulfate, and Citrate were developed and their performance characteristics determined by. It has not been cleared or approved by the US Food and Drug Administration. Page 1 of 5 Date Printed: 5/9/2006 V1/LLK0092

2 Pediatric Chemistry Data Values larger, bolder and more towards red indicate increasing risk for kidney stone formation. Ca 24 Ox 24 Cit 24 UA 24 P 24 Mg 24 SAMPLE ID SS CaOx /Kg 2 /1.73m /Cr 24 ph /1.73m 2 /Kg /Kg HEIGHT WEIGHT 08/03/05 S ABBR. ANALYTE TREATMENT RECOMMENDATION SS CaOx Supersaturation CaOx Reduce levels by raising urine volume and citrate, lowering urine oxalate and calcium. Ca 24/Kg Ox 24/1.73 m 2 Cit 24/Cr hr calcium per Kg 24 hr oxalate / 1.73 m2 24 hr citrate / 24 hr creatinine mg/kg; <3.7 both genders; if not associated with hypercalcemia consider thiazide diuretic. (Arch Dis Child 49:97, 1974) ph 24 hr urine ph Low ph can cause uric acid stones, treat with alkali; if>8 consider urea splitting infection. UA 24/1.73 m 2 P 24/Kg Mg 24/Kg 24 hr uric acid / 1.73 m2 24 hr phosphorous / Kg 24 hr magnesium / Kg mg/kg/24 hr; low in poor nutrition or bowel disease. Height Height in cm Obtained from treating physician or patient. Weight Body Weight in Kg Obtained from treating physician or patient. mg/1.73 m 2 /24 hr; high from diet excess, severe elevation consider genetic cause or bowel disease. mg citrate/gr creat; male >130, female >300; if low consider potassium citrate. (J Pediatr 92:394, 1978) gram/1.73 m 2 /24 hr; <0.81 both genders; high from diet or inborn errors of purine metabolism. (J Pediatr 92:911, 1978) mg/kg/24 hr; low in poor nutrition or bowel disease, high from diet intake especially dairy. Page 2 of 5 Date Printed: 5/9/2006

3 Pediatric rmal Ranges Chemistry AGE MALE MEAN MALE SD FEMALE MEAN FEMALE SD SS CaOx Ca 24/Kg Ox24/1.73m Cit 24/Cr ph Ua24/1.73m P 24/Kg Mg 24/Kg Page 3 of 5 Date Printed: 5/9/2006

4 Values larger, bolder and more towards red indicate increasing risk for kidney stone formation. See reverse for further details. Stone Risk Factors / Cystine Screening: Negative (08/05/2005) SAMPLE ID Vol 24 SS CaOx Ca 24 Ox 24 Cit 24 SS CaP ph SS UA UA 24 08/03/05 S NORMAL RANGE 0.5-4L 6-10 male <250 female < male >450 female > male <0.800 female <0.750 Dietary Factors SAMPLE ID Na 24 K 24 Mg 24 P 24 Nh4 24 Cl 24 Sul 24 UUN 24 PCR 08/03/05 S NORMAL RANGE Renal Function rmalized Values SAMPLE ID WEIGHT Cr 24 Cr 24/Kg C Cr Ca 24/Kg Ca 24/Cr 24 08/03/05 S NORMAL RANGE male female male >100 female >90 <4 <140 Page 4 of 5 Date Printed: 5/9/2006

5 Clinical Report The clinical information shown below was obtained directly from your patient during our telephone interview, and, where possible, from medical records forwarded from your office. Stone Morbitity BEFORE TREATMENT First Stone Date: 06/08/2005 N/A Total Stones: 2 0 ER Visits: 0 0 Hospital Visits: 0 0 Infections: 0 0 Cystoscopies: 1 0 Lithotripsies: 0 0 Operations: 0 0 AFTER TREATMENT Treatment Began: N/A 11/02/2005 Family History Surgical History Dietary History START STOP Medication History DRUG (DOSE/DAY) START STOP Related Diseases EVENT DIAGNOSED = Before Treatment = After Treatment Father had stones: Mother had stones: Number of siblings: 1 Siblings with stones: 0 Number of children: 0 Children with stones: 0 Contributing Factors Hot or dry environment: Limited access to restroom: Long term immobilization: Long term steroid therapy: Kidney removed: Page 5 of 5 Date Printed: 5/9/2006

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